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Recently proposed changes in anthropometric evaluation of nutritional status of infants: a critical assessment

Some changes in the evaluation of nutritional status through anthropometry have recently been proposed in prestigious national and international publications. These changes consist of the substitution of "Harvard" anthropometric standards and of the weight/age criteria of the "Gomez Classification". The objections to the traditional methodology and the new proposals are critically analysed in the light of the theory which favours the anthropometric evaluation of nutritional status. From the analysis it is evident that: a) the adoption of new anthropometric standards ("Santo André Classe IV" e "NCHS") is fully justified, although little effect is to be expected from it; b) the adoption of standard percentiles to express cut-off points is an important step forward when a wide age-range is under examination or more than one anthropometric indicator is involved; c) the extreme lowering of cut-off points, and the underlying unilateral concern with diagnostic specificity are not justifiable in our context where malnutrition is not a rare event; d) at some ages, the continuous observation of weight/age may result in greater advantages than the introduction of new indicators such as height/age or weight/height, Also it is evident that the appropriateness of anthropometric criteria in the evaluation of nutrional status can not be properly appraised without the explicitation of the purposes of the evaluation and of the endemic level of malnutrition in the population under examination.

Anthropometry; Children; Nutritional status; Malnutrition


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